Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study of motor nerve conduction velocities in median, ulnar, peroneal and tibial nerves bilaterally in 50 hemiplegic patients revealed a statistically significant slowing in the affected limbs compared with the unaffected side. The decrease of nerve conduction velocity was not related to any of the following factors: duration of stroke, degree of paralysis, degree of spasticity, side of paralysis, age of patients, and sex ef patients. The results can indicate that lower motor neurons are indeed affected by upper motor neuron lesions. The slowing of the nerve conduction velocity of motor peripheral nerves is probably due to the loss of trophic influence from higher centres or its decline. The author suggests that this phenomenon leads to a selective deterioration of thick nerve fibres while only thinner ones continue conducting impulses.
 ...
PMID:[Conduction in the motor neurons of the peripheral nerves in hemiplegia of cerebral origin]. 651 16

Although the therapeutic effect of spinal cord stimulation (SCS) for spastic movement disorders is still controversial, its effect for multiple sclerosis has been supported by several authors. Among various clinical beneficial effects, reduction of the spasticity may be attractive for physical therapy of post-apoplectic patients. Two patients suffered from post-apoplectic spastic hemiplegia were selected for SCS. Electrodes of Medtronic's SCS system were placed at lower cervical or upper thoracic spinal cord extradura. Stimulation of 30-75 Hz in frequency and 0.3-0.5 in voltage continued for 12-14 hours during daytime every days. U.S., a 74-year-old man, suffered from cerebral infarction in the right internal capsule was treated by SCS at one year after the stroke . At the fourth day after SCS spasticity of the lower extremity reduced and his gait improved remarkably. Upper extremity also showed reduction of spasticity at the seventh day after SCS. H/M ratio before SCS was 0.85 and reduced to 0.77 at 68 th day after SCS. Recovery curve of H-wave also improved after SCS. Y.K., a 47-year-old man, suffered from pontine hemorrhage showed right spastic hemiplegia. He was treated by SCS at 13th month after the hemorrhage. Spasticity of the upper extremity reduced slightly and his gait improved obviously. H/M ratio which was 1.05 before SCS, reduced to 0.75 at 122 nd day after SCS. Recovery curve of H-wave improved remarkably after the treatment. It was obvious that the spasticity reduced after SCS and function of the extremities recovered to some extent in above patients.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Spinal cord stimulation for post-apoplectic spastic hemiplegia]. 661 Aug 36

The rehabilitation of hemiplegic patients is often prolonged by the problem of painful shoulder. The specific etiology of this problem is controversial and treatment does not always produce the desired results. Thirty hemiplegic patients with painful, stiff ipsilateral shoulder joints were studied. The mean interval from the onset of stroke to the onset of painful shoulder was 3 months. On shoulder arthrography, 23 patients had capsular constriction typical of frozen shoulder (adhesive capsulitis). Seven patients had normal arthrograms. None showed rotator cuff or capsular tears. Electromyography revealed electrical silence in the shoulder musculature at rest. These findings indicate that the painful, stiff shoulder developing after hemiplegia is not caused by rotator cuff tear or by spasticity, but probably has a pathogenesis similar to that of idiopathic frozen shoulder.
 ...
PMID:Arthrographic studies in painful hemiplegic shoulders. 671 51

An examination for hemiparetic patients is proposed on the basis of which a rehabilitation program can be elaborated. The extent of the examination renders it suitable for in-patient departments in acute and subacute conditions after stroke. All values of examination have commentary texts which are often not to be found in newly suggested forms so that examinations cannot be standardized. Furthermore the formal aspect of the form is emphasized with lucidity and clarity of the printed model. Three main aspects are quantified: 1) activities of daily living, 2) the elementary movements of limb segments, 3) the muscle tonus--so-called spasticity. The study was stimulated by a long-term clinical and research follow-up of the mentioned problem at the Neurological Clinic in Prague.
 ...
PMID:Standard examination for rehabilitation from central hemiparesis. 710 Aug 34

Return of neurologic function after a stroke tends to be complete within six months after the insult. Initial flaccidity is superseded by spasticity, which is most prominent distally. Movements initially occur in synergistic patterns. Return of voluntary movements begins proximally in the lower extremity. In the upper extremity, proximal recovery usually occurs first, but finger movement occasionally is the earliest sign. Proper positioning and early, passive range-of-motion exercises help to avoid complications.
 ...
PMID:Stroke rehabilitation: Part II. Recovery and complications. 714 38

The charts of twenty-nine patients who had undergone thirty musculocutaneous neurectomies for acquired spasticity of the elbow in a non-functional upper extremity were reviewed. The most common causes of the spasticity were cerebrovascular accident (59 per cent) and head injury (24 per cent). The aims of the operation were to increase the patient's capacity for self-care and to improve ambulation, personal hygiene, and appearance. Patients who had 30-degree flexion contractures preoperatively did not require a cast postoperatively; those who had 30 to 75-degree flexion contractures preoperatively required a cast postoperatively; and patients who had flexion contractures of more than 75 degrees preoperatively required a concomitant release of soft tissue in the elbow and application of a cast postoperatively. One patient who was operated on to improve appearance had no active elbow flexion postoperatively and was regarded as having a poor result. Musculocutaneous neurectomy is a safe, reliable procedure for treating the spastic elbow in the non-functional upper extremity.
 ...
PMID:Musculocutaneous neurectomy for spastic elbow flexion in non-functional upper extremities in adults. 735 1

Patients with a motor deficit due to ischaemic stroke usually develop muscular spasticity, but in some cases they may remain with a prolonged muscular flaccidity which impairs their recovery. Little is known about the causes of these two different functional outcomes. We correlated CT/MRI and 99mTc HM-PAO SPECT with clinical findings in 42 patients at a mean time interval of 3 months after stroke. The patients were divided into two cohorts with either flaccid (prolonged muscular flaccidity) or spastic (muscular spasticity) hemiparesis. Although patients with prolonged muscular flaccidity had a greater motor deficit, the mean structural volume of the ischaemic lesion was similar to that of the muscular spasticity cohort. There was a significantly higher prevalence of structural involvement of the lentiform nucleus in prolonged muscular flaccidity cases. Relative perfusion in the lentiform nucleus, thalamus and contralateral cerebellar hemisphere was significantly lower in prolonged muscular flaccidity than in muscular spasticity patients. A subgroup with only subcortical structural lesions also showed significantly lower relative perfusion in the ipsilateral frontal association areas. A primary involvement of the lentiform nucleus by the structural lesion seems to be crucial for the persistence of flaccidity after stroke. However, cerebral blood flow (CBF) changes in other structurally intact regions indicate their additional role. It is likely that both subcortical-cortical loops involved in motor control, i.e. cortex-basal ganglia-thalamus-cortex and cortex-pons-cerebellum-thalamus-cortex, are more widely and more severely affected in patients with prolonged muscular flaccidity.
 ...
PMID:Prolonged muscular flaccidity after stroke. Morphological and functional brain alterations. 749 90

Shoulder-hand syndrome developed in 36 (27%) of 132 hemiplegic patients in a prospective study. Subluxation, paresis of the shoulder girdle, moderate spasticity, and deficits in confrontation visual field testing were the major risk factors. In a placebo-controlled, nonblinded trial, 31 of the 36 patients became almost symptom free within 10 days' treatment with low doses of oral corticosteroids. Shoulder joint capsules taken at autopsy of 7 patients showed signs of previous trauma of the affected shoulder. In the second part of this study on another 86 patients, early awareness of potential injuries to shoulder joint structures reduced the frequency of shoulder-hand syndrome from 27 to 8%. These clinical findings suggest that shoulder-hand syndrome in hemiplegia is initiated by peripheral lesions. A self-perpetuating vicious cycle may be established, followed by the clinical picture of a "reflex sympathetic dystrophy." In the majority of stroke patients, this clinical phenomenon seems to be preventable by avoiding shoulder trauma.
 ...
PMID:The shoulder-hand syndrome after stroke: a prospective clinical trial. 752 74

The H-reflex recovery curve of the lower limb is considered a useful test for the diagnosis of spasticity, and recently the reciprocal inhibition of the H-reflex has proven to be abnormal in patients affected with spasticity. We studied the H-reflex recovery curve and the reciprocal inhibition of the H-reflex in the upper limb of a group of 33 patients with different degrees of spasticity secondary to stroke. Results were compared with those of 25 controls. The aim of this study was to investigate if the two tests showed any direct correlation with the degree of spasticity and, furthermore, with other clinical measures that are present in patients with spasticity as part of an upper motoneuron syndrome (i.e., changes in muscle tone, reflexes, force, etc.). The results showed an abnormality of both tests in most patients (decrease of the three phases of inhibition in the reciprocal inhibition test and increase of the late facilitation part of the H-reflex recovery curve), and these abnormalities seem mostly to be related to muscle tone, most important being the degree of correlation between tone and changes in abnormality of the H-reflex recovery curve (P < 0.03).
 ...
PMID:H-reflex recovery curve and reciprocal inhibition of H-reflex of the upper limbs in patients with spasticity secondary to stroke. 757 12

A 64-year-old man had an ischemic stroke in the left parietotemporal cortical-subcortical areas. He developed a severe right spastic hemiparesis and dysphasia. An angiographic study showed left internal carotid artery occlusion and right internal carotid artery stenosis. A right internal endoarteriectomy was performed without any clinical improvement. After 1 year the patient was a candidate for cervical spinal cord stimulation (SCS) for the treatment of his spastic hemiparesis. An epidural electrode (Medtronic Sigma 3483) was positioned at the cervical level, mediodorsal to the cord. Clinical and neurophysiological studies (surface polyelectromyography, PEMG, for evaluation of brain motor control) were performed before and after 7 days of SCS (0.2 ms, 80 c/s, intensity for paresthesiae, continuous mode). A transcranial Doppler (TCD) study of both middle cerebral arteries (MCA) at rest and during SCS was performed on two occasions. SCS was followed by improvement of voluntary movement, decrease of spasticity and better endurance. The clinical findings were confirmed by the PEMG recordings. TCD examination showed an increase of flow velocities on both the right MCA (+43%) and the left MCA (+130%) during SCS. Such a TCD pattern, suggesting an increase of cerebral blood flow (CBF) during SCS, was reproducible. This case confirms efficacy of SCS in the treatment of ischemic hemiparesis and the increase of CBF following cervical SCS in man. The marked increase of CBF, particularly evident on the ischemic side, may play a role in mediating the improvement of motor control in our patient together with a possible arousal of the so-called 'sleeping neurons' of the penumbra zone.
 ...
PMID:Increase of cerebral blood flow and improvement of brain motor control following spinal cord stimulation in ischemic spastic hemiparesis. 763 Oct 53


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>